Our Service Industry Sucks

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I sort of feel like ranting a little, but am too tired from lack of sleep, so I’ll just state the obvious.  The service industry in the United States sucks.  Pretty much straight across the board.

And it’s not just limited to the people who are supposed to be able to fix our automobiles, electronics, or homes.  It is just about everyone.  I’m not sure if it is because of lack of education or just that stuff is way too complicated to be fixed, but whatever the reason, it is a fact.

This is the probably 70% of the reason that I learned to fix things myself.  I got sick and tired of getting back, whatever was supposed to be repaired, and it worked worse than it did when I took it in.   I figure that attempting to fix something that I know nothing about isn’t that big of a risk considering the high chances it not being fixed by someone who claims to be knowledgeable. It is the reason we live in such a disposable society.

I know that medical care/dentistry/insurance is not really part of the service industry, but it is sort of what got me thinking about this whole thing.

When I fell and broke my hip, I bit my lip and put a gash in it.   That was nearly 5 months ago.  I’ve had this thing in my mouth, some scare tissue or swollen gland, that I just keep biting.  When I saw my dentist, who is great, up in Winona, he told me that it wouldn’t get better on its own and I needed it cut out.

So yesterday, I had an appointment to go to an oral surgeon and get it removed.  It wasn’t such a big deal, but the whole thing went badly.  First, they couldn’t get a hold of my insurance  to figure out if it was covered.  They finally got through to them and my insurance told them that they didn’t have an record of me.  Then the called back and said that I didn’t have an dental insurance.

I had explained to the oral surgery people that I didn’t think it was a dental problem, it seemed more like a tissue deal.  They agreed, but said that they only had dental billing codes.  They don’t have normal medical billing codes that they could submit.  I thought that was strange.  They said that when they send the tissue in for a biopsy, that maybe they will put on the regular billing code and not a dental code.  Maybe?

Anyway, the oral surgeon seemed competent.  It took about 20 minutes and he was sort of training a new assistant.  I was getting my lip yanked around like crazy, they were having a hard time keeping hold of it because it was so slick.  They kept using more and more gauze so they could get a good grip on it.

So, they cut out the gland and some surround tissue and then stitched it up.  It only took three stitches and felt okay because it was numb.

I paid them the $355 and left.  The stitches were supposed to dissolve on their own.  Little did I know that they would be gone almost instantly.  By the time I went t the pharmacy to get a prescription filled, I could taste blood in my mouth.  When I got back out to my car, I looked in the rear view mirror and saw that the bottom half was open and was bleeding.   It was just a little over an hour since it had been done.

So I just drove back over there, but no luck, there wasn’t anyone there but 2 receptionists and one assistant.  All the doctors had left and it was hardly 3. They looked in my chart and said there were three stitches.   I told them that there were only two left.  I thought they would call the oral surgeon and ask him what they should do, but no.

The dental assistant came back with a plastic bag full of gauze and told me to keep applying pressure until the bleeding stopped.   They were pretty much heading out the door and I realized that was all the service I was going to receive.

I was thinking I wasn’t looking forward to going back this morning and getting it put back in.  Then, a couple hours later, I felt this small piece of thread in my mouth and there was another stitch.  And just a bit later, the third one came out.  So, I had a big hole in my inside lip.

This morning I got a call from the receptionist.  She told me they consulted with the doctor and he said that as long as it wasn’t bleeding, it should be fine.  I told her that all the stitches were gone and she said they could schedule me for an appointment, but it should heal fine.

Maybe all the receptionists there have went to dental school too, but I very much doubt it.  I’m not sure where she got the knowledge she passed on to me.  If it’s true, then I’m sort of unsure why he even put in stitches to start with.

Now I’m thinking about whether I should have just taken some sutures and re-stitched  it back up myself. I sort of have this “rule” that I don’t do any stitches above the shoulders.   But when I start having more confidence in my ability to stitch up my mouth than going back to an oral surgeon, something is wrong with the scenario from the start.

I’m having a hard time convincing myself that I don’t want to go back in, but I have don’t have much confidence in the place either, so it’s a catch 22.

Anyway, I didn’t sleep much last night, as I wrote earlier.  I have physical therapy for my hip at 10:15 and don’t really feel much like going.  It’s gonna be one of those days I think.

I don't have all this stuff, but I do have some sutures that would work.

I don’t have all this stuff, but I do have some sutures that would work.

On Tuesdays, the group meets at PT after the ride to have a beer.  It worked out great yesterday because of the Royals playoff game was going on simultaneously.

On Tuesdays, the group meets at PT after the ride to have a beer. It worked out great yesterday because of the Royals playoff game was going on simultaneously.



26 thoughts on “Our Service Industry Sucks

  1. dog

    I’d file a complaint with your state’s medical board. At the very least, the surgeon should have made his way back to the office and had a look at your wound and then made his decision on what to NOT do. There’s a thing called a “standard of care” required by a medical doctor and you didn’t receive it.

  2. m

    Steve, here’s my two cents. When the economy slows the only way to continue to grow or maintain is through increased efficiency. When the economy tanked in the last 7 years inefficient businesses went under and the only way for existing businesses to make more money was manage the bottom line not the top line. So people focused on expenses not growth…because there is no growth why invest in growth oriented tactics like customer service. As the result, the businesses squeezed all they could out of their cash flow and service suffered. The other to thing that drives customer service is competition. You’d think a slowing economy would increase competition but it actually eliminates competition. Now one goes above and beyond, they just hunker down to preserve wealth. That’s why company profits are up in a down economy. They simply cut the bells and whistles, like customer service. When the economy begins to rebound you will see competition again and these guys will have to step up their game. I don’t buy the fact that a slowing economy means we work harder. I think we simply eliminate or reduce the customer experience to maintain status quo. One last example. The real estate market grew and then collapsed. Those that survived didn’t so it by marketing, a top line strategy. They did it by hunkering down, a bottom line strategy. Those remaining have very little competition. As the real estate market picks up, so will competition and so will customer service, a top-line tactic not a bottom line one.

  3. Kris Walker

    I would put the stitches back in or go to your family doctor to have them put back in. Otherwise, it may not heal well and you will have a bigger scar than you started with. The surgeon sounds like a piece of *

  4. mark

    Agree Steve. What we all have come to except as the norm in Customer Service would not have been tolerated years ago. I blame the high pace technology culture as the main culprit. There was a time when you could drive into a gas station to fill up and be greeted by 3 uniformed mechanics who would promptly take care of your needs w/o having to get out of the car. Or one used to be able to call a company and actually speak to a human ( who speaks good english ), instead of listening to music on hold with endless msgs of how your business is appreciated. I watched an old movie the other day and noticed an elevator operator helping people find what they were looking for, WOW have things changed.

  5. Jeff Butterfield

    This is another example that illustrates that we live in a “P” world. Given Honors, Pass or Fail options, the majority are satisfied with Pass — do just enough to get by. Heaven forbid they should strive for excellence.

  6. Johnny Bugno

    Now that Andy Rooney is in kvetch heaven looks like you’ve found your calling

    Look out 60 Minutes, here comes Tilford!

  7. The Cyclist

    This is outrageous. You should demand to have your money back, and give them a bill for suffering.

  8. tclaynm

    Man, you said it. You can’t rely on very many people to do a good job in this world. It’s pathetic. I have also taken to attempting (most times, successfully) to fix things I know nothing about because the options are so grim and the bad outcome certain.

    It’s our slow progression toward what that Mike Judge movie, “Idiocracy” depicted. Your story is just another example of how that movie’s prophecy is actually coming to fruition!

  9. Bryan

    I am in Customer Service taking phone calls and doing my best to help my callers. As much as you hear the old saying “the customer is always right”, well, sometimes they are wrong. It is difficult to tell them that in such a way as not to make them feel insulted. I have done such jobs now for over 7 years and still the audacity of what a caller expects you to do for them often amazes me.

    When I worked phones for Alltel I had a caller once that demanded we remove over $5,000 in text message charges from their bill. They didn’t even try and dispute the charges were not valid – they just demanded to have the charges removed. In other words, they wanted all that network usage for nothing. They were quite upset when I told them I couldn’t do that. I offered them a compromise, but they refused. It finally came down to the call center manager telling them no, and at this point since they had went through four levels of managment, each offering the same compromise, and they had refused all of them – well the manager would not even give that.

    I don’t know what the person finally did – either they paid the bill or it went into collections and their service was cancelled. I wish I could say that was the exception, but in 7 years of Customer Service I’ve come to realize that it is the norm, not the exception.

  10. channel_zero

    This seems appropriate: http://www.georgia-medicareplans.com/att-retiree-health-insurance-plan-cancelled/

    Aon is a large employee benefit conglomerate that has secured a contract with AT&T to provide “counseling” services to retirees. You have probably received your notice from AT&T and may have had a call from a counselor that want’s to schedule a phone interview.

    Retiree’s that contacted us for advice have indicated their counselor seems to have very little understanding of how Medicare works and what your options. The advice seems to be little more than reading from a prepared script on a computer screen.

    Go America!

  11. The Cyclist

    This is so wrong on so many levels. As a customer you have no rights against these kind of companies. I’ve worked for many years very close to the top management of one of them. The customers were not even regarded as people.

  12. Ryan

    Sounds like a mucocele. I had a similar operation many years ago and it went much more smoothly. I still have a scar, but the giant blob I kept biting is gone for good. Good luck.

  13. Allen

    Too bad you didn’t see my oral surgeon, Dr Krueger. He and his crew did a fabulous job of fixing my broken jaw after a nasty crash last year. His team treated me great and i am thankful to them everyday for piecing me back together.

  14. Ken

    The inside of the mouth should heal fine without sutures. I’m guessing the initial sutures are placed just to stop bleeding (a tamponading of the hemorrhage) and not really necessary for healing. So, the nurse would be correct in stating that as long as it’s not bleeding it will heal fine.

    Last week I had to educate my optometrist on the inaccuracy of his phoroptor in accurately measuring my refraction. He could barely understand why his phoroptor gave me a correction in my right eye of -7.25 dioptors when I could see perfectly well at -6.25. An in-training optometry assistant (she couldn’t have been more than 21) understood it better. She deserved the examination fee, not the optometrist.

  15. Levi

    It is astonishing to me, how it seems that every square inch of your body has been affected by bike crashes.

  16. Todd

    Hi Steve- you saw my cousin, Dr. Jim McCreight, in Steamboat a while back. When I read you were in Steamboat and having dental issues, I hoped you would find Jim. As I continued to scroll down the post, I finally saw the photo of you and Jim so I knew you were in good hands!

    I happen to be in the dental field, as well. As an Oral and Maxillofacial Surgeon (OMS) I can tell you that your experience was not what I consider the standard of care. At the very least, when patients call us after hours, they always have the option of speaking with our on-call surgeon, for any questions, 24-7. Additionally, receptionists typically are not encouraged to dispense medical or dental advice.

    Sutures can fall out too soon although it is a rare occurance that all would come out so rapidly. Many lip incision/biopsy sites can heal without sutures but it takes longer and it is not as comfortable for the patient.

    Most procedures that are categorized as biopsies or benign lesion removal of the oral cavity, lips and face are coded/billed medically with CPT codes and appropriate diagnosis codes (ICD-9). Rarely do we code them dentally, unless the patient only has dental insurance and not medical. Then, a CDT code is submitted, but those codes are much more generalized than medical coding.

    While there is some crossover with medical and dental coding, most OMSs have team members trained in both medical and dental insurance billing. Oftentimes, patients see dentists who perform oral surgery or are periodontists but not actually Oral Surgeons. That might explain their confusion with billing your biopsy medically. Otherwise, I can’t fathom why they would have difficulty with it.

    Best advice I can give you is to speak honestly with the doctor who treated you. He or she (or another doctor in the practice) should be available to you by phone anytime. Most dentists/oral surgeons are truly concerned about their patients’ well-being and put patient care/excellent customer service as their top priority.

    I hope you have a speedy recovery.

    Of note, my OMS partner and I are both avid cyclists- I have been since I bought my first Team Crest jersey when I was 14, training and racing on a Nishiki Rally. That Crest jersey is now framed and up on the wall at our practice along with a matching Team Crest Cannondale. Who knew cycling would eventually guide me to dental school?

    Keep up the great work with your site- I read your posts every day!

    M. Todd Brandt, DDS, MD

  17. Chris Newell

    I totally understand EVERYTHING you are saying. I have no idea how we’ve gotten here but something needs to change. BTW if I ever get to provide mechanic service on your bike you won’t be disappointed… I will make sure your service is worth it unlike doctors or a bunch of our current society.

  18. H Luce

    Well, I realize that Roto-Rooter isn’t the same as a dentist, but here’s a story:

    Back towards when we had the torrential rains in June, I noticed a stench – like putrid water which had been standing for a while in organic matter – in my basement. I cleaned up the water and forgot about it. Then in September we had a bunch of rainstorms and it got really bad, and so I decided to have a good look at the window well drain, where the water was seeping in at the bottom of the (openable) window. Aha! that was it, I figured. It was clogged full of leaves and dirt, probably not having been cleaned since I moved in almost 9 years ago if then – because the window well was covered with polycarbonate plastic secured by liquid nails or some other adhesive to the brick walls… So I cleaned out the drain, pressure hosed it with water, vacuumed the water and foul-smelling gunk out, re-hosed it, re-vacuumed, repeat 3 times until the drain worked fine. Finished, or so I thought. Just to rule out one possibility, I went upstairs and dumped four buckets of water down the toilet just to make sure it wasn’t the toilet draining into the window well … and you could guess it – water welling out of the drain into the basement. Time to call a plumber. Luckily I had a toilet on the other side of the house with what I thought was a second independent stack and drain, so I used that – and no use of shower or tub or sink. I called CallPat.com and they sent a guy out the next day, showing up at 12 noon. I explained what happened, showed him what I thought was the main stack and drain and showed him the back stack and drain as well. He checked, found no front sewer line, and he figured that the front line actually went *under* the house, was totally clogged, and it would require excavation of the basement to get to the line at probably close to $30,000 in expense by the time I was done. Then he went out to his truck, called his boss – and then shook his head, told me they had no interest in attempting to do the job, and advised me, after a bit of back and forth, to call the Topeka Roto-Rooter.

    So that’s what I did, called them up, and they sent out their guy, showed him the set-up including the back stack and drain, and then he said “I’ve seen this before. What you have is this stack going down to a trap at the foundation, then going around the house, making two 90 degree bends before joining the sewer drain, which is in the back…” I said the real estate agent who sold me the house couldn’t get a camera down the drain and he said he wasn’t surprised. Long story made a bit shorter, we decided to abandon and seal the front drain and run the front stack to the back drain and install a cleanout, in PVC… And he quoted me a price of $2200, 25% down. Sold. And now I’ve got a dry, non-stenchy basement, in addition to clean window wells. The week after, I asked him for a quote on replacing the 11 year old water heater with corroded relief valve – and had him do that too. So the answer is in Topeka, if you’ve got a plumbing problem – or need some plumbing work done, call Roto-Rooter and ask for Stephen. He’s proud of his craft, which he learned from his father, he’s been doing it for 40 years, and it shows.

  19. Bryan

    What is wrong? What the customer expected as their “right” or what they were given, which was nothing as they would not accept a compromise? Or that they expected us to remove it all?

    They were billed correctly so why would they expect to have it all erased?

  20. dog

    Make the original surgeon fix it. That’s what he’s supposed to have done anyway. His craftsmanship sucked and it caused to wound to open back up again. Fail.


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